Causes for Neuropathic pain

Neuropathic pain develops from a lesion or disease affecting our nervous system. Neuropathic pain can be acute or persistent. Acute neuropathic pain is treatable, whereas chronic neuropathic pain is a complex, needs to be treated for months and in some cases for years.

Acute neuropathic pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. Acute pain might be caused by many events or circumstances, including: surgery, broken bones, dental work, burns or cuts, labor and childbirth. Acute pain might be mild and last just a moment, or it might be severe and last for weeks or months. In most cases, acute pain does not last longer than six months, and it disappears when the underlying cause of pain has been treated or has healed.

Unrelieved acute pain, however, might lead to be chronic neuropathic pain. On the other hand, persistent neuropathic pain persists although the injury has healed. Pain signals remain active in the nervous system for weeks, months, or years. Physical effects include tense muscles, limited mobility, a lack of energy, and changes in appetite. Emotional effects include depression, anger, anxiety, and fear of re-injury. Such a fear might hinder a person’s ability to return to normal work or leisure activities.

Recent epidemiological reports estimate around 116 million Americans are suffering with chronic neuropathic pain. The cost is enormous, approximately $ 600 billion per annum in terms of treatment and inability to work or lost productivity.

The stimulus-evoked neuropathic pain is that the non-noxious stimuli may be painful. Clinically, it is called as allodynia. For example, a gentle touch with cotton wisp or a foam brush may evoke pain. Another condition of stimulus-evoked pain is called hyperalgesia. Here a noxious stimulus may produce a greater than a normal response.

There are numerous drugs and drug classes available when treating neuropathic pain. Doctors, specialized in pain management, have the option of choosing the right treatment for you. It is based on accurate diagnosis, associated diseases and patient's history. The risk of developing chronic neuropathic pain and the responses to analgesics vary considerably between individuals. Therefore, the treatment depends on several factors: (1) whether, the pain is due to injury or surgery or disease or for unknown reasons (2) age and sex of the patient.

Unfortunately, treatment with these different classes of drugs remains wearisome to both patients and doctors, because of delayed onset of analgesia and extensive side effects. Some patients may respond well to Aleve or Motrin (anti-inflammatory drugs) treatments. Tricyclic antidepressants may ease pain in some conditions. In another condition, such as diabetes, a combination of different classes of drugs may alleviate the pain. Additionally, some patients may require stronger painkillers, such as morphine. For these reasons, it is better to discuss with your doctor if one class of drugs doesn’t work for you.

Topical Therapies

Topical therapies such as patches, creams, ointments, gels that can be applied directly to the site of injury provide relief from neuropathic pain.

Psychological Therapies

Daily intake of painkillers, frequent visits to hospitals, fewer social interactions and financial problems can cause severe psychological distress (anxiety and depression) in patients suffering with chronic neuropathic pain. Be prepared, if your doctor makes a referral for appropriate psychological therapies. This will help you to understand the mind-body connection to control pain. Common therapies include relaxation techniques, hypnosis, imagery, meditation and yoga.

Thalamus is one of the prominent areas within the brain that plays a significant role in pain processing. It is deeply buried under the motor cortex. Some research has shown that long-term stimulation of the thalamus soothes pain.

Future analgesic drug development

Neuropathic pain perception in humans and animals, nonetheless, displays considerable, and unexplained, interindividual variability. It has long been asked why some people experience more pain than others, why some patients receive fewer benefits from existing analgesics, and why some of them are more prone to chronic pain. This interindividual variability has been linked to genes. In recent years, genetic studies of pain have identified candidate genes involved in interindividual pain sensitivity as new molecular targets for novel analgesic drug development.

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